Department of Otorhinolaryngology, All India Institute of Medical Sciences, Jodhpur, India.
Department of Diagnostic and Interventional, Radiology, All India Institute of Medical Sciences, Jodhpur, India.
Laryngoscope. 2024 Nov;134(11):4736-4744. doi: 10.1002/lary.31565. Epub 2024 Jun 11.
This study aims to discern the disparities in the electrode-to-modiolus distance (EMD) between cochleostomy and round window approaches when performed sequentially in the same temporal bone. Additionally, the study seeks to identify the cochlear metrics that contribute to these differences.
A cross-sectional study was conducted, involving the sequential insertion of a 12-electrode array through both round window and cochleostomy approaches in cadaveric temporal bones. Postimplantation high-resolution CT scans were employed to calculate various parameters.
A total of 12 temporal bones were included in the imaging analysis, revealing a mean cochlear duct length of 32.892 mm. The EMD demonstrated a gradual increase from electrode 1 (C1) in the apex (1.9 ± 0.07 mm; n = 24) to electrode 12 (C12) in the basal turn (4.6 ± 0.24 mm; n = 12; p < 0.01). Significantly higher EMD values were observed in the cochleostomy group. Correlation analysis indicated a strong positive correlation between EMD and cochlear perimeter (CP) (r = 0.64; n = 12; p = 0.03) and a strong negative correlation with the depth of insertion (DOI) in both the middle and basal turns (r = - 0.78; n = 20; p < 0.01). Additionally, EMD showed a strong negative correlation with the DOI-CP ratio (r = -0.81; n = 12; p < 0.01).
The cochleostomy group exhibited a significantly higher EMD compared with the round window group. The strong negative correlation between EMD and DOI-CP ratio suggests that in larger cochleae with shallower insertions, EMD is greater than in smaller cochleae with deeper insertions.
NA Laryngoscope, 134:4736-4744, 2024.
本研究旨在探讨在同一颞骨中先后行耳蜗造瘘术和圆窗入路时，电极至耳蜗底回（modiolus）的距离（EMD）的差异，并确定导致这些差异的耳蜗参数。
本研究采用回顾性的尸体颞骨研究方法，对 12 具尸体颞骨行耳蜗造瘘术和圆窗入路先后植入 12 电极的研究，术后进行高分辨率 CT 扫描以计算各种参数。
共纳入 12 具颞骨进行影像学分析，耳蜗管平均长度为 32.892mm。EMD 从电极 1（C1）的顶点（1.9±0.07mm；n=24）逐渐增加至基底回电极 12（C12）（4.6±0.24mm；n=12；p<0.01）。耳蜗造瘘组的 EMD 值明显更高。相关性分析显示 EMD 与耳蜗周长（CP）呈强正相关（r=0.64；n=12；p=0.03），与中、底回的插入深度（DOI）呈强负相关（r=-0.78；n=20；p<0.01）。此外，EMD 与 DOI-CP 比值呈强负相关（r=-0.81；n=12；p<0.01）。
与圆窗组相比，耳蜗造瘘组的 EMD 明显更高。EMD 与 DOI-CP 比值呈强负相关，提示在插入较浅的较大耳蜗中，EMD 大于插入较深的较小耳蜗。
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喉科学，134：4736-4744，2024。
